ADULT PROTECTIVE SERVICES Rachel Richards, Adult Protective Services Department Analyst Department of Human Services, O

1. ADULT PROTECTIVE SERVICESRachel Richards, Adult Protective Services Department AnalystDepartment of Human Services, Office of Adult Services7109 W. Saginaw, First FloorLansing, MI 48917517/ 373-0007ADULT PROTECTIVE SERVICES HOTLINE: 1-800-996-6228

2. National Statistics It is estimated there are between 2 and 5 million victims each year Studies estimate that only 1 in 5 cases are reported Over two-thirds of abusers are family members An estimated 5-10% of seniors (age 65 and older) will experience abuse or neglect National Center on Elder Abuse

3. 2004 Michigan Statistics 14,437 reports of suspected abuse, neglect or exploitation to Adult Protective Services (APS) 9,284 reports were investigated by APS 2,833 investigations concluded with substantiated abuse, neglect or exploitation against a vulnerable adult 5,718 referrals received involved an adult age 60 + 5,721 referrals received were regarding a female

4. Michigan Statistics Continued 65% of case determinations were neglect 39% Self Neglect 26% Neglect 15% were abuse 8% Physical Abuse 6% Emotional Abuse 1% Sexual Abuse 13% were exploitation

5. Adult Protective Services Purpose To provide protection to vulnerable adults age 18 years and older as mandated by Public Act 519 of 1982 Justification for Investigation The alleged victim is an adult at risk of harm from abuse, neglect or exploitation and there is reasonable belief that the alleged victim is vulnerable and in need of protective services Vulnerable Adult: An adult as defined by the Social Welfare Act, (MCL 400.11), namely: (a.) A person 18 years or older, (b.) Who has a condition in which said person is unable to protect himself or herself from abuse, neglect or exploitation because of a mental or physical impairment or because of advanced age Goals Immediate (within 24 hours) investigation and assessment of situations when a vulnerable adult is suspected of being or believed to be abused, neglected or exploited Assure adults in need of protection are living in a safe and stable situation including legal intervention, where required, in the least intrusive or restrictive manner possible

6. Definitions Abuse Harm or threatened harm to an adult�s health or welfare caused by another person. Abuse includes non-accidental physical, mental or sexual abuse. Neglect Harm to an adult�s health or welfare caused by an inability of the adult to respond to a harmful situation or by the conduct of a person who assumes responsibility for a significant aspect of the adult�s health or welfare. (failure to provide adequate food, clothing, shelter, medical care, etc.) Self-Neglect Behavior by an adult that threatens his or her own health and safety. Exploitation An action involving the misuse of an adult�s funds, property or personal dignity by another person

7. Mandated ReportersThose employed, licensed, registered or certified to provide or who are employees of an agency licensed to provide: a. Health Care b. Education Services c. Social Welfare Services d. Mental Health Services e. Other Human ServicesLaw Enforcement OfficersEmployees of the County Medical ExaminerPhysicians

8. APS Philosophy Guidelines Always attempt to involve the adult�s family, friends and support community in the solution as determined by your individual � Assist individual�s in helping themselves move towards greater independent functioning in the least restrictive setting of their (the individual�s) choice � Recognize the extent of the individual�s capacity for self-care and self-determination � Tailor offered services to the needs and wishes of the individual � A competent individual has the right to refuse services � Court ordered Guardianships and Conservatorships are the last resort for protection � The grounds for intervention must be rooted in law and the reasons for intervention must be compelling

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11. Procedure APS referral is received by the local office APS Coordinator determines whether there is sufficient information to determine there is a vulnerable adult who is at risk of harm (abuse, neglect and/or exploitation) Investigation commences within 24 hours of receipt of complaint. APS worker is to make one contact within 24 hours by phone or in person with either the client or a collateral contact (someone other than the referral source with pertinent information related to the client and allegations. A face to face contact with the client must occur within 72 hours (immediately if the complaint indicates the possibility of physical danger to the client) The APS worker is to make a determination of the nature, extent and cause of the abuse, neglect or exploitation through examination of the evidence gathered The APS worker determines the adult�s capacity for self-care and management of personal and financial affairs and that adult�s willingness and capacity to use available resources and services The APS worker must determine if the allegations of abuse, neglect or exploitation are substantiated or unsubstantiated

12. APS Policy Elements for APS Worker Investigation per the APS Statute � A determination of the nature, extent and cause of the abuse, neglect or exploitation � Examination of the evidence � Identification, when possible, of the person(s) responsible for the abuse, neglect or exploitation � Names and conditions of other individuals in the place of residence � Evaluation of the person(s) responsible for the abuse, neglect or exploitation � Environment of the residence � Relationship of the alleged victim to the person responsible for their care � Evaluation of the adult�s consent to receiving protective services � Adult�s capacity for self-care and management of their personal and financial affairs � Adult�s willingness and capacity to use available resources and services � Extent to which natural helping network (family, friends, neighbors, church) is available, capable and willing to provide protection and help Extent of needed community resources available

13. Agency Coordination of Investigations Office of Children and Adult Licensing (OCAL) OCAL investigates: � Violations of licensing rules and regulations in licensed facilities � Employees of OCAL licensed facilities who are alleged to have abused, neglected or exploited residents of that facility and if the alleged harm occurred in the facility Joint OCAL/DHS investigations: � APS is mandated to investigate alleged abuse, neglect or exploitation of individuals in licensed Adult Foster Care Homes. � APS is mandated to investigate and determine if harm occurred and to protect the vulnerable adult. OCAL investigates to determine possible regulatory violations. � Coordination of investigative efforts is key in providing a thorough and accurate report Complaint Intake Unit toll free at 866-856-0126

14. Community Mental Health/Office of Recipient Rights � APS is investigating allegations of abuse, neglect and exploitation and providing protection as needed. � Office of Recipient Rights is investigating whether or not the individual�s rights have been violated � OCAL is to investigate any regulatory violations � Law Enforcement may also be involved if there are allegations that are criminal in nature. Contact your local Office of Recipient Rights to file a complaint Department of Community Health/Mental Health state funded and operated facilities DHS/APS investigates only when the alleged incident occurred prior to admission to the facility, the alleged abuse was committed by a non staff person within the facility, while the alleged victim was off the premises in the custody of another person or organization or when the alleged victim was on leave of absence from the facility MDCH Complaint Division: 1-800-882-6006

15. Nursing Homes/Hospitals APS investigates only when the alleged incident occurred prior to admission to the facility, the alleged abuse was committed by a non-staff person within the facility or while the alleged victim was on leave from the facility MDCH Complaint Division 1-800-882-6006 APS and Domestic Violence DV involves a crime, therefore the appropriate law enforcement agency has primary responsibility for investigation and resolution of the immediate complaint APS referrals of DV are received in the same manner as other APS complaints APS Complaint Coordinator should consult with law enforcement to discuss proper coordination of roles and responsibilities Legal aid agencies and private attorneys may be consulted regarding need for domestic abuse injunctions If the victim of DV is also vulnerable as defined by APS policy, APS workers should offer appropriate supportive and/or protective services (I.e.: referral to DV shelters, Adult Foster Care if applicable, any other services deemed necessary)

16. Coordination with Law Enforcement and the Prosecutor�s Office � APS is required to report all information received which is criminal in nature to Law Enforcement. � Law Enforcement is the investigative body responsible for determining violations of law. � APS� mandate from the Social Welfare Act to protect vulnerable adults and ensure they are in a safe and stable environment continues. � We must cooperate and build working relationships with local Law Enforcement (State Police, County Sheriff Department, City Police Department, Prosecutor�s Office). Local DHS office should cooperate with county Prosecutor�s office in criminal investigations and should make the results of any APS investigation and all other client related information available to assist in such investigations � When working with other agencies and interests compete, APS must put the welfare of the client first before the interest of other agencies.